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Biomedical subjects

D Fontaine

Publications and source records attributed to D Fontaine.

At least 37 records · Page 2Linked to original sources
PubMed1998

Absorption, tolerability, and effects on mitochondrial activity of oral coenzyme Q10 in parkinsonian patients.

We report a pilot study of three oral doses of coenzyme Q10 (CoQ10) (200 mg administered two, three, or four times per day for 1 month) in 15 subjects with Parkinson's disease. Oral CoQ10 caused a substantial increase in the plasma CoQ10 level. It was well tolerated, but at the highest dose (200 mg four times per day) mild, transient changes in the urine were noted. CoQ10 did not change the mean score on the motor portion of the Unified Parkinson's Disease Rating Scale. There was a trend toward an increase in complex I activity in the subjects.

Absorption↗
PubMed1998

[Guidelines for evaluating the viability of health care centers: test in northern Cameroon].

A working group has developed a manual of practical guidelines for evaluating the viability of health care centers (HCC). These guidelines were tested in 1996 at the HCC in Badjouma, Cameroon. Viability is assessed in three dimensions, i.e. quality of care, cost-effectiveness, and institutional efficacy on the basis of the demand for services, staff requirements, cash flow, and supply costs. Regular evaluation of these parameters allows identification of areas requiring improvement to enhance the viability of the HCC. With only 0.29 visits per year per inhabitant, the attendance rate at the Badjouma facility is low. Public appeal is adversely affected by an under-qualified staff and poor equipment. Overall operating expenses are 6.8 million CFA francs per year and depreciation costs are 1.7 million CFA francs per year. Direct proceeds related to health care services (mainly sale of medication) are 4.1 million CFA francs. The remaining sources of revenue are state subsidies (2.5 million CFA francs) and international aid (0.4 million CFA francs). The deficit is 1.5 million CFA francs corresponding mainly to depreciation costs. Evaluation of the financial viability based on service-generated revenues alone (49%) and on combined domestic revenues, i.e. service revenues and state subsidies (79%), shows that the HCC depends mainly on depreciation costs. Analysis of institutional efficacy by comparing real activity with activity defined in official texts showed that the state was the main decision-maker but also revealed a tendency to pass off responsibility due to poorly defined command structure. The results of this test validate the proposed manual as a tool for global analysis of the activity and relevance of a HCC. Findings can be used to draw conclusions on the effects of national health policies at the local level.

Cameroon↗
PubMed1998

[Lower limb spasticity in adults. Clinical evaluation with motor block].

Clinical assessment of spastic lower limbs in adults requires identification of neurologic components (motor deficit, spasticity, co-contraction, sensory deficit) and non-neurological components (contracture) of the motor disorder and the intrinsic mechanism of the "spastic" gait. In order to determine the nature of a complex motor disorder, the clinical can call on different diagnostic tools such as motor blocks or gait analysis measuring time-distance parameters, kinematic, kinetics, gait dynamic electromyography and energy expenditure for gait performance. Clinical assessment is guided by the therapeutic goal (function, gait, mobility, pain relief, nursing), both to propose treatment and objectively monitor treatment results in terms of deficit (strength, flexibility, appropriate contraction, muscle activation) and handicap (gait, transfers, activities of daily living).

Adult↗
PubMed1997

[Approaches for a systemic modelling of health programs].

The aim of this paper is to achieve a systemic model to describe a health programme taking into account the influence of the actors. The data were collected via interviews with 15 people collaborating on two programmes: screening of colorectal cancer using the Hémoccult II test in France, and restructuring health services in a district in Guinea. The results stress that a public and community health programme can be described as a self-organizing, dynamic, observing and observed system. With a systemic approach, a programme can be modelled according to three steps. First, preliminaries: although initially motivated by the wish to improve the system, the intervention on it meets with resistance to any change. This stage proposes to open an "intervention space" including the definition of an appropriate framework, and the modelling of the problematic situation. Second, change: this stage brings new standards in the system. The more useful, the more suited to the mind of the collaborators and the more integrated into the existing social networks, the more easily the changes are welcomed. Finally, autonomization: the regulations of the system contribute to maintain the new standards, and thus to strengthen the changes. In conclusion, in the initial purpose to improve its operational capabilities, an intervention on a local part of the social and health system may, on the contrary, cause troubles. The systemic approach proposes a scenario in order to deal with this complexity. It also gives new insights for planning, implementing, and assessing health programmes.

Colorectal Neoplasms↗
PubMed1997

Mass screening programs for breast cancer in France--average values of assessment criteria.

Breast cancer is the most common cancer in women worldwide. Many studies have been performed worldwide to assess the effectiveness of screening in terms of reduced mortality due to breast cancer. Since the end of 1989, 10 breast cancer mass screening programs using mammography have been carried out in France under the sponsorship of the National Fund for Health Prevention, Education, and Information (FNPEIS) from the National Health Insurance of Salaried Workers (CNAMTS). These 10 campaigns, which are on a district scale, are organized according to variable methods and are assessed using a common procedure. Four groups of criteria are measured in this procedure, which investigates the impact, quality, effectiveness, and costs of screening programs. The average and extreme values of each criterion as calculated from the campaigns are presented in this paper. In order to enlighten the judgment on the French results, a comparison with the international standards in force and with the results of foreign screening programs is proposed.

Aged↗
PubMed1997

[Mass screening programs for breast cancer in France. Comparative evaluation].

OBJECTIVE: The purpose of this work was to comparatively assess the results of mass screening programs for breast cancer implemented in six French departments in 1986, within the scope of the National Fund for Health Prevention, Education and Information of the National Health Insurance Office of Salaried Workers. MATERIAL AND METHODS: The data collected by the screening centres were analyzed by ten assessment teams that were independent from the program promotion staff, all using the same evaluation form. A complementary population study performed in eight French districts then, allowed assessing the frequency of self-referred screening (mammography performed out of program). RESULTS: The rate of participation in screening programs, in relation to the invited population, ranged from 21 to 48%, according to the district (36% in average). This low participation was probably related to the extent of self-referred screening. In fact, 19 to 40% of women, according to the district, had previously had a screening mammographic coverage: rate was around 68% in women aged 50 to 69 years. Positive findings with mammography ranged from 4.5 to 15.8% (10.1% in average), while intervention rates ranged from 0.7 to 1.6% and detection rates from 3.8 to 6.2%. The ratio between benign tumors and cancers ranged from 0.7 to 2.1 according to the district. In order to enlighten the judgement on French results, we propose a comparison with the international standards in force. CONCLUSION: The various experiences with breast cancer screening in France show that this screening is technically feasible on the basis of existing medical structures. However, some criteria are still below the expected values, especially if compared with international standards. This result is probably accounted for by the high rate self-referred screening before age 40 in France. In these conditions, the question is whether extending breast cancer screening programs in France is an appropriate course of action.

Breast Neoplasms↗
PubMed1997

[Effect of ion exchange resins on the composition of milk].

Pretreatment of milk with either sodium or calcium polystyrene sulfonate resins is useful in limiting potassium dietary intake in children with renal failure. We therefore studied the in vitro effects of Kayexalate and Calcium Sorbisterit on potassium, sodium and calcium concentrations in 3 standard formulas and in human milk. It is concluded that wide variations in the final potassium, sodium and calcium concentrations can be observed according to the resin but also to the formula.

Animals↗
PubMed1995

Recognition, assessment, and treatment of anxiety in the critical care patient.

A multidisciplinary group of experts involved in the treatment of critically ill patients participated in a workshop conference designed to develop practice recommendations for the recognition, assessment, and treatment of anxiety in the critical care environment. Anxiety was identified as a ubiquitous problem in critical care that may interfere with healing and recovery. The faculty agreed that clinicians should be familiar with the signs and symptoms of anxiety and should be able to determine when interventions are necessary. Whenever possible, nonpharmacologic methods for anxiolysis should be incorporated into intensive care protocols. Intensive care personnel should be trained in those interventions that require specialized expertise, and they should become familiar with the drugs available for the treatment of anxiety. Protocols for determining the best agents to be used in a given setting and their most appropriate method of administration should be established. Pharmacologic and nonpharmacologic treatments are not mutually exclusive but should be complementary. Finally, procedures for obtaining psychiatric consultation, when necessary, should be in place.

Adaptation, Psychological↗
PubMed1994

An intelligent Computer-Assisted Instruction system for clinical case teaching.

The use of computers in the field of medical education is common. Our purpose is to present a Computer-Assisted Instruction system which has been developed over ten years at the University of Compiègne and the University of Rennes Medical School. This system can be used to help the student to solve clinical cases by analyzing and critiquing their answers and by using a knowledge base which has been previously structured in a rule network. It is an intelligent Computer-Assisted Instruction system comprising an author module, a pedagogical module and a student module. The CAI system can be used as a simulation model for any type of diagnostic or therapeutic problem. In this paper we present the author and pedagogical module which have been built using our previous work on intelligent computer-assisted instruction systems.

Artificial Intelligence↗
PubMed1990

[Endobronchial lipoma: a potential CT diagnosis].

Bronchial lipomas are rare and benign neoplasms. Computed tomography can provide a powerful adjunct to conventional modalities in determining the nature of an endobronchial lesion. The reflex vasoconstriction can also be nicely depicted.

Bronchial Neoplasms↗
PubMed1989

Analysis of complex Y chromosome aberrations using a single DNA probe (Y-367).

A specific cloned DNA sequence (Y-367) detects at least four loci in the euchromatic long arm and in the short arm of the human Y chromosome. Deletion mapping assigns one locus to the distal euchromatic long arm, another to a region close to the centromere on either Yq or Yp, and two additional loci to the Y short arm. Y-367 may thus be used for the rapid screening of even complex Y chromosome aberrations. This is exemplified in a 45,X male with Y chromosome material on the long arm of chromosome 10 by the detection of an inversion of a portion of Yp and by the confirmation of duplications and deletions in two individuals with duplications of part of the Y chromosome.

Chromosome Aberrations↗